| Sexually-Transmitted Profits
Merck, God and the War Over the HPV Vaccine
Pierre Tristam/Candide's Notebooks, February 8, 2007
Initially the thought of a vaccine that protects against the sexually transmitted human papillomavirus (HPV) and doubles up as a guard against cervical cancer seemed like a no-brainer: Cheryl and I have an almost-thirteen-year-old daughter, we were looking and asking around to see how and when to get the three shots regardless of the seemingly ridiculous expense. But $360 is a breeze if it buys the projected health benefits. The fact that the Christian right is opposed to the vaccine, on the assumption that it would condone pre-marital sex, encouraged us to seek it out even more. I pray that any daughter of mine will never be so foolish as to turn down the opportunities and pleasures of premarital sex, often, if not quite early: it can wait a few years. It shouldn’t wait until marriage (if it’s a fun and lasting marriage you want, as opposed to a creepy claustrophobic and Catholic one). I just don’t see how a vaccine designed to prevent two diseases, one of them cancer for god’s sake (three diseases, if you include gay men: the HPV vaccine also helps prevent anal cancer in gay men), has anything to do with dictating the timetable of an individual’s sexual activity, as the religious right thinks. Then again, the religious right being the sexually obsessive organism that it is, will happily inflict every cancer under the sun on anyone as long as no sex is being engaged in pre-maritally (or good sex post-maritally).
For all that, we started having questions about the vaccine when we learned that twenty states are debating bills that would make the vaccine mandatory for 10 and 11 year-old girls, and that Merck & Co., the pharmaceutical company, is the vaccine’s exclusive manufacturer. Merck is obviously, lavishly lobbying for the bills. It stands to reap billions of dollars from the cornered market. “The vaccine,” Bloomberg reports, “is Merck’s most important new product, capable of generating as much as $3 billion in annual sales, analysts said. Revenue from Gardasil in the fourth quarter reached $155 million.” Gardasil is the product in question. Also, Merck’s stock has shot up 32 percent in the past 12 months, “the best return among the 14 members of the Standard & Poor’s 500 Pharmaceutical Index.” When a pharmaceutical company is the primary driver behind a medical requirement, the debate might as well be held in a Tiananamen Square of red flags.
More questions: It is a new vaccine. Its side-effects are yet uncharted. Who’s to say that while preventing a cancer it isn’t opening the door to equally debilitating diseases, or—and this we certainly don’t know—affecting a girl’s eventual sexual life? That possibility might mitigate the Christian right’s opposition to the vaccine. It would be a deal-breaker for me: the risks of cervical cancer are so slight anymore, at least in the United States that perhaps foregoing the vaccine in order to ensure against the possibility of worse side-effects begins to make sense. I’m not sure, although the numbers support a less panicked approach: about 3,700 American women die of cervical cancer each year according to vaccine proponents, 10,000 new cases are diagnosed a year. Big numbers if you’re one of those diagnosed, but not if you admit some perspective: There will be some 680,000 new cancer diagnoses overall this year, and 273,560 anticipated cancer deaths among American women, 41,000 of breast cancer, 72,000 of lung cancer. We have a cancer problem. Cervical cancer, once in the top 10, doesn’t even make it on the list anymore.
And then there’s this final issue: Making certain vaccines—for measles, mumps, rubella, polio, chicken pox—mandatory is justified. Those are known debilitating and contagious diseases. Contagious through relatively casual contact. But HPV is transmitted only sexually, and not quite easily: boys and girls aren’t humping each other in classrooms. The fact that they are engaging in sexual activity at early ages in some cases (there’s been more Dr. Phil-generated hype about a an early-sex epidemic than fact) isn’t in itself a compelling reason to blanket entire student bodies with vaccine requirements as a response: It is a contagious disease in a different category, and a specifically private category so far as individuals, and particularly students, are concerned. So making it mandatory isn’t an overriding public health necessity. If anything, it puts the state in an overriding, big-brotherish position over the individual and her family, and it does so, for the first time, by making a vaccine requirement gender-specific, also something of a red flag: The vaccine has been shown to have equal benefits for gay men when it comes to anal cancer, but will Texas make it mandatory for gay men, or all boys, to submit, too? Not likely.
I would unquestionably be opposed to a mandatory AIDS vaccine should one became available. What makes an HPV vaccine different? More questions than answers. But that’s what sorting this issue out is about. As always with matters of sex and young girls, leave it to the United States to skimp around the issue with gloves and earplugs on, instead of delving into it openly and candidly.